The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Jul 2008
Comparative StudyEarly operation on patients with a hip fracture improved the ability to return to independent living. A prospective study of 850 patients.
The outcome for many patients with a hip fracture remains poor. The aim of the present study was to investigate whether the timing of surgery in such patients could influence the short-term clinical outcome. ⋯ Early compared with late operative treatment of patients with a hip fracture is associated with an improved ability to return to independent living, a reduced risk for the development of pressure ulcers, and a shortened hospital stay.
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Patients with diabetes mellitus have higher complication rates following both open and closed management of ankle fractures. Diabetic patients with neuropathy or vasculopathy have higher complication rates than both diabetic patients without these comorbidities and nondiabetic patients. ⋯ Careful soft-tissue management as well as stable, rigid internal fixation are crucial to obtaining a good outcome. Prolonged non-weight-bearing and subsequently protected weight-bearing are recommended following both operative and nonoperative management of ankle fractures in patients with diabetes.
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J Bone Joint Surg Am · Jul 2008
Randomized Controlled Trial Comparative StudyThe efficacy of combined popliteal and ankle blocks in forefoot surgery.
Postoperative pain following forefoot surgery can be difficult to control with oral analgesia. The aim of this study was to compare the efficacy of a combined popliteal and ankle block with that of an ankle block alone in providing postoperative analgesia following forefoot surgery. ⋯ A popliteal block in conjunction with an ankle block provides significantly better pain relief than does an ankle block alone in patients undergoing forefoot surgery.
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J Bone Joint Surg Am · Jul 2008
Large osteochondral fractures of the lateral femoral condyle in the adolescent: outcome of bioabsorbable pin fixation.
Large osteochondral fractures of the lateral femoral condyle of the knee in adolescent patients can be diagnostically and therapeutically challenging. Historically, management has involved removal of the fragment, leaving a large area of bone devoid of articular cartilage on the weight-bearing surface of the lateral femoral condyle. This study assessed open reduction and internal fixation of the osteochondral fragments with use of multiple polyglycolic acid rods. ⋯ Osteochondral fracture of the lateral femoral condyle is an injury to which adolescents with ligamentous laxity of the knee are prone. Our results show that internal fixation of these osteochondral fragments with bioabsorbable implants is possible and is a worthwhile option.